Type 1 Diabetes

In type 1 diabetes, the beta-cells in the pancreas that produce insulin are gradually destroyed; eventually insulin deficiency is absolute. Without insulin to move glucose into cells, blood sugar levels become excessively high, a condition known as hyperglycemia. Because the body cannot utilize the sugar, it spills over into the urine and is lost. Weakness, weight loss, and excessive hunger and thirst are among the consequences of this "starvation in the midst of plenty". Patients become dependent on administered insulin for survival. (Sometimes type 1 patients can experience remission and go off insulin, but these "honeymoon" periods are virtually never permanent; they usually occur shortly after diagnosis and are short-lived.)

Type 2 Diabetes

Type 2 diabetes is by far the more common diabetes. Most type 2 diabetics appear to produce variable -- even normal -- amounts of insulin, but have abnormalities in liver and muscle cells that resist its action. Insulin attaches to the receptors of cells, but glucose does not get insidea condition known as insulin resistance. Because many type 2 diabetics seem to be incapable of secreting enough insulin to overcome this resistance, however, it is likely that in such cases there is an additional defect in insulin secretion by the beta-cells. While many patients can control type 2 diabetes with diet or with medications that stimulate the pancreas to release insulin, commonly the condition worsens and may require insulin administration. Maturity-onset diabetes in youth (MODY) is a rare genetic form of type 2 diabetes that usually develops in thin teenagers. About 0.5% of pregnant women develop a form of type 2 diabetes called gestational diabetes in their third trimester.

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